Providing primary care to patients with mental illness is a challenging task that requires highly skilled and experienced practitioners comfortable with the full array of biopsychosocial problems with which these patients present. For example, understanding the side-effect profiles of the psychiatric medications and their impact on problems such as diabetes and other complex endocrinopathies requires highly evolved clinical skills. Optimally, the successful care of these patients is best provided in close collaboration among the entire health team including the prescribing psychiatrist and the primary care provider. Indeed, integrated care models are becoming more prevalent with patients being cared for by primary care and behavioral health teams, collaborating and/or collocated in the same practice using a single electronic health record (EHR). Many behavioral health practices are considering adding primary care services in order to better address these whole person healthcare needs. In the NextGen® Advisors’ conversations with behavioral health and physician groups across the country, we find several challenges that groups are universally grappling with. These are not easy decisions, as the differences between the foundational skill sets of these providers are nuanced and often somewhat opaque to a behavioral health leadership team.